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Is the risk of preeclampsia higher when a woman has only one kidney? Are there possible long term effects/kidney damage in this situation? My daughter had a kidney removed two years ago for congenital UPJ. It was atrophied, but infected after 25 years without a clue. She is now almost 40 wk gest. and just diagnosed w/ preeclampsia, being admitted for induction. Thank you.

If she is 40 weeks and being induced the probability of success is high. It also depends what was meant by preeclampsia as the spectrum of severity at time of diagnosis is very variable but most term preeclampsia is of the Ã¢â‚¬Å“milderÃ¢â‚¬Â form.

There are not very much data on single kidney studies but the general consensus is the women with congenital single kidneys have generally successful pregnancies without any indication of increased preeclampsia. Women with single kidneys who lost their other kidney because of obstruction, and especially after infectious problems have more problems but still do fairly well. Even women with single kidneys secondary to transplantation do well, and all these prognoses are based on having normal or near normal function at time of conception, and no hypertension. Likewise there seems to be little evidence that pregnancy has any adverse effects on the long term prognosis of the kidney,. The same is true for women with transplanted kidneys, the consensus being that if gestation takes place with preserved renal function and no hypertension long term prognosis is not affected.

Paradoxically, there is a small but suggestive literature the women who donate their kidneys have more preeclampsia if they conceive after than before donation, but there are confounding variables here. Again data is limited.

In essence all varieties of renal Ã¢â‚¬Å“problemsÃ¢â‚¬Â (disease, transplant, single kidney) follow the dictum that in the presence of preserved function and normotension the outlook is good without any remote problems.